Lack of “obesity paradox” in patients presenting with ST-segment elevation myocardial infarction including cardiogenic shock

• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Verfasst von: Ansari, Uzair [VerfasserIn]
• Titel: Lack of “obesity paradox” in patients presenting with ST-segment elevation myocardial infarction including cardiogenic shock
• Titelzusatz: a multicenter German network registry analysis
• Verf.angabe: Ibrahim Akin, Henrik Schneider, Christoph A. Nienaber, Werner Jung, Mike Lübke, Andreas Rillig, Uzair Ansari, Nina Wunderlich and Ralf Birkemeyer
• E-Jahr: 2015
• Jahr: 11 July 2015
• Umfang: 8 S.
• Fussnoten: Gesehen am 18.01.2018
• Titel Quelle: Enthalten in: BMC cardiovascular disorders
• Ort Quelle: London : BioMed Central, 2001
• Jahr Quelle: 2015
• Band/Heft Quelle: 15(2015) Artikel-Nummer 67, 8 Seiten
• ISSN Quelle: 1471-2261
• DOI: doi:10.1186/s12872-015-0065-6
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Cardiogenic shock
• Sach-SW: Coronary stent
• Sach-SW: Mortality
• Sach-SW: Obesity paradox
• K10plus-PPN: 1567329063

Abstract

Background: Studies have associated obesity with better outcomes in comparison to non-obese patients after elective and emergency coronary revascularization. However, these findings might have been influenced by patient selection. Therefore we thought to look into the obesity paradox in a consecutive network STEMI population. Methods: The database of two German myocardial infarction network registries were combined and data from a total of 890 consecutive patients admitted and treated for acute STEMI including cardiogenic shock and cardiopulmonary resuscitation according to standardized protocols were analyzed. Patients were categorized in normal weight (≤24.9 kg/m2), overweight (25-30 kg/m2) and obese (>30 kg/m2) according to BMI. Results: Baseline clinical parameters revealed a higher comorbidity index for overweight and obese patients; 1-year follow-up comparison between varying groups revealed similar rates of all-cause death (9.1 % vs. 8.3 % vs. 6.2 %; p = 0.50), major adverse cardiac and cerebrovascular [MACCE (15.1 % vs. 13.4 % vs. 10.2 %; p = 0.53)] and target vessel revascularization in survivors [TVR (7.0 % vs. 5.0 % vs. 4.0 %; p = 0.47)] with normal weight when compared to overweight or obese patients. These results persisted after risk-adjustment for heterogeneous baseline characteristics of groups. An analysis of patients suffering from cardiogenic shock showed no impact of BMI on clinical endpoints. Conclusion: Our data from two network systems in Germany revealed no evidence of an “obesity paradox”in an all-comer STEMI population including patients with cardiogenic shock.